Background

To determine the relative impact of five proposed barriers to physician usage of advance directives with the aim of increasing the number of advance directives generated.

Methods

Questionnaires were sent to 460 internal medicine resident and attending physicians at a large New Nork, NY, hospital.

Of these, 277 (60%) responded.

We used multiple regression to measure the impact of five barriers to physician-initiated discussions of advance directives (time constraints, compensation concerns, discomfort with the subject, beliefs about appropriateness, and lack of understanding) on respondents'estimates of the number of advance directives held by respondents'patients, the number ofrecent advance direcrive discussions, and the number of discussions initiated by physicians.